Kim Kardashian and her husband Kanye West welcomed a third child on Tuesday after the couple’s surrogate gave birth to a baby girl, according to news reports. Kardashian previously documented her decision to use a surrogate on “Keeping Up With the Kardashians,” an E! reality show about her and her family, saying it was “the only other option” after a doctor told her it would be medically dangerous for her to carry another child. (Kardashian’s representative did not immediately respond to request for comment).

“We are incredibly grateful to our surrogate who made our dreams come true with the greatest gift one could give and to our wonderful doctors and nurses for their special care,” Kim Kardashian wrote on her website. The new daughter will join sister North, 4, and Saint, 2.

The price tag for the pregnancy? Upwards of $100,000, including a fee directly to the surrogate of $45,000 and a deposit to the surrogacy agency of nearly $70,000, according to TMZ. Celebrities aren’t the only ones who pay those high prices. That’s actually broadly in line with the $98,000 to $140,000 national average, according to surrogacy agency ConceiveAbilities. The medication alone used for in vitro fertilization costs thousands of dollars, and fees for a full surrogacy including childbirth costs can be more than $50,000.

Affordability depends largely on location, said Stephanie Caballero, founder of Surrogacy Law Center in Southern California, which specializes in reproductive law. Illinois is one of 15 states mandates insurance coverage for infertility, which can save couples thousands on IVF, embryo transfer, and drugs. “You can save $20,000 just from moving to another state,” Cabellero, who also hired surrogates herself for her two children said. “I’ve considered it, and many people have done it.”

Couples looking to hire a surrogate generally contact an agency and find a match to carry their child. There are two kinds of surrogates: “traditional surrogacy,” wherein a woman is artificially inseminated with the client’s sperm and delivers a biological baby for them to raise, or “gestational surrogacy,” where an embryo from a mother and father is implanted using in vitro fertilization into the uterus of the surrogate. The gestational surrogate then carries the child, who has no genetic ties to her, to birth. Kardashian planned to use this form of surrogacy, she said on her show.

Surrogacy contracts include a fee paid to the surrogate directly and often higher fees for additional embryos carried in the case of multiples. Contracts can contain specific stipulations regarding diet and behavior: In Kardashian’s case, TMZ reported the surrogate cannot smoke, drink or do drugs during the pregnancy and must refrain from going in hot tubs, handling cat litter, and applying hair dye. She cannot eat raw fish or drink more than one caffeinated beverage a day, TMZ said.

Often parents will pay for clothing and other pregnancy-related costs for a surrogate, Cabellero said, though not everyone has Kardashian’s millions. “For the average person, is it easy? No,” she said. “But can it be done? Yes.”

Hundreds of would-be parents have created pages on GoFundMe for such procedures and even held bake sales to raise funds for a family. In her own case, Caballero said, all disposable income between her and her husband went towards a future pregnancy for years. “People will do anything when they can’t carry to hire a surrogate,” she said. “You get to the point where you just start seeing babies everywhere.”

Sometimes, a relative will volunteer to carry the child, which can significantly lower costs. Kardashian considered the option on this season of her show. While Kardashian has more resources than most aspiring parents, she could experience problems the average couple exploring surrogacy do not, including the prying eyes of the paparazzi. The surrogate who actress Sarah Jessica Parker hired to carry her twin babies in 2009 was identified by the media and hounded for photos and information. Police in her town were investigated for breaking into her home for information to sell to tabloids.

Surrogacy companies require women to undergo a psychological screening and legal evaluation before agreeing to the process and being matched with a couple, said Jane Frederick, a board-certified reproductive endocrinologist and fertility expert in Orange County, Calif. In most places, the law is on the side of the intended parent, not the surrogate, and cases of a surrogate trying to keep the baby are rare. While some surrogates are primarily seeking extra income, many of them simply enjoy pregnancy.

“Their thoughts are, ‘I had such an easy pregnancy and want to help someone trying to conceive who has had difficulty,’” she said. “In their mind it’s something that comes easily.”

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